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[Closed] STW collective medical knowledge: Anti-TNF-Alpha and Crohn's disease

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 Kit
Posts: 24
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1) What do you good folks know about anti-TNF alpha drugs in relation to treament of Crohn's disease?

2) What does fistulising mean?

Most of the info online seems to be medical journals I can't get access to. Am asking because this is as it is suspected I have an external manifestation only of Crohn's and anti-TNF-alpha drugs have been suggested as a possible course of treatment, as have steroids. Interested in any info anyone has!

Ta,
Kit


 
Posted : 30/10/2009 12:04 pm
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Fistulising = forming a [url= http://en.wikipedia.org/wiki/Fistula ]fistula[/url].
Don't know about anti-TNF, sorry.


 
Posted : 30/10/2009 12:08 pm
 Kit
Posts: 24
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Grim, but fortunately not applicable.


 
Posted : 30/10/2009 12:11 pm
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My missus is on anti-TNF but for arthritis / Anocholising Spondalitis (spelling??). Probably not relevant...

I might be able to get access to journals through Uni still if you have any specifics - mail me if you'd like me to try.


 
Posted : 30/10/2009 12:12 pm
 Kit
Posts: 24
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Cheers jimmy, I'll drop you an email when I've done a bit more googling.


 
Posted : 30/10/2009 12:25 pm
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There's a comprehensive review here
http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD006893/frame.html
Also try looking on PubMed
http://www.ncbi.nlm.nih.gov/pubmed
you may not be able to get the full articles but the summaries are free to non-subscribers


 
Posted : 30/10/2009 12:28 pm
 Kit
Posts: 24
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Cheers hilldodger, that first link looks good.


 
Posted : 30/10/2009 12:42 pm
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My missus is on anti-TNF but for arthritis / Anocholising Spondalitis (spelling??). Probably not relevant...

Ankylosing Spondylitis and Crohn's are related somehow, my brother has both which isn't unusual. I'll ask him what he takes


 
Posted : 30/10/2009 1:14 pm
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Crohn's disease
Infliximab has been shown to have benefits in severe active Crohn's disease.16 NICE were due to review around July 2008 but this has been delayed until early 2009.17

[i]NICE guidance18 recommends that the following criteria should be fulfilled:.

•The Crohn's disease should be severe and active.
•The Crohn's disease is refractory to other drugs (azathioprine, steroids, methotrexate etc) or patients have been intolerant of these drugs.
•Patients for whom surgery is inappropriate.
It is not recommended for fistulising Crohn's disease.[/i]

From here; [url]
http://www.patient.co.uk/doctor/Anti-tumour-Necrosis-Factor-Alpha-(anti-TNF-alpha).htm [/url]


 
Posted : 30/10/2009 3:18 pm
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[url] http://en.wikipedia.org/wiki/Infliximab [/url]


 
Posted : 30/10/2009 3:19 pm
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Ankylosing spondylitis and crohns both have excess TNF (tumor necrosis factor) as a major symptom in common.
(Broadly speaking) TNF's normal function is good, it will identify and kill both viruses and potentially cancerous cells, however when there is an excess, it seems to get a bit bored and starts causing problems in normally healthy people.
Anti TNF drugs serve to either inhibit (block) or "soak up" excess TNF.
I dont know much about crohns, but do know a little bit about anti TNFs, let me know if you've got any specific questions.

Im guessing jimmy's missus and ebygumm's brother are both using etanercept (enbrel)?
but I doubt you'll be using this, as i dont think it's licenced (yet) for crohns.


 
Posted : 30/10/2009 3:27 pm
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Look here

,the site is good for information and support,I used to work in Gastro-enterology.Most departments have a specialist nurse,who will be good for info too.
Ian


 
Posted : 30/10/2009 3:49 pm
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Sorry,should point out,infliximab is most common anti-TNF used for Crohn's,the effects and side-effects are similar throughout the group.
Ian


 
Posted : 30/10/2009 3:50 pm
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[url= http://www.ispub.com/ispub/ijrh/volume_5_number_2_39/management_of_inadequate_response_to_tnf_antagonist_therapy_in_rheumatoid_arthritis_what_are_the_options/tnf-fig2_thumbnail.jp g" target="_blank">http://www.ispub.com/ispub/ijrh/volume_5_number_2_39/management_of_inadequate_response_to_tnf_antagonist_therapy_in_rheumatoid_arthritis_what_are_the_options/tnf-fig2_thumbnail.jp g"/> [/img][/url]

A good article (free) on TNF about Rh arthritis with some nice piccies 🙂

Essentially its an antibody directed against TNF alpha - therefore the bodies immune system removes the molecule (cytokine) from the body like it would with a virus etc. thus reducing the concentration in teh blood system and tissues.


 
Posted : 30/10/2009 3:55 pm
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try cks.nhs.co.uk or gpnotebook for info


 
Posted : 30/10/2009 4:07 pm
 Kit
Posts: 24
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Excellent, thanks very much folks (knew you'd come good). A little reading over the weekend.


 
Posted : 30/10/2009 4:12 pm
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just dont ask how they make the antibodies

if you are a veggie it may cause some issues


 
Posted : 30/10/2009 4:15 pm
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Hi TNFalpha. Tumour necrosis factor alpha (it's nothing to due with cancer in this instance it's just where it was first found) is a protein that is released during auto-immune reactions. The TNFalpha antibody basically takes TNFalpha out of circulation due to a standard immunue response reaction.

It can have dramatic positive effects.I had a mate a few years ago who almost couldn't walk due to Rh arthritis and he was back to normal almost in a few days. Amazing really. No idea what it does for Crohn's - sorry.


 
Posted : 30/10/2009 4:19 pm
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is a protein that is released during auto-immune reactions

but also is part of the normal immune reactions in the body 😉 just to clarify !


 
Posted : 30/10/2009 4:26 pm
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Hi Kit, the National Association for Cronhs and Colitis (NACC) is very informative and helpful and should be able to help you with info and research. You may need to become a member (this is fairly cheap) if you haven't already done so. You can also write to their magazine to request to be contacted by others in a similar position to yourself - see the above link from thejesmonddingo


 
Posted : 30/10/2009 5:54 pm